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PACE: Beyond Intervals

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Al Sears, MD, claims to have a new and better way to do
intervals. Sears says it’s beyond intervals. He makes the case in PACE:
The 12-minute Fitness Revolution (Wellness Research & Consulting, 2010). It
may be the best mass-market book on the merits and application of interval
training.

Interval training has worked for elite athletes since the
late 1930s, when a German runner used it to set a world record for 800 meters
that lasted for 16 years. In 1954, Roger Bannister incorporated intervals into
his training and became the first man in history to run a mile under four
minutes. Al Sears, one of the first doctors to be board-certified in anti-aging
medicine, says his approach makes intervals work better for everyone. To stake
his claim, he registered the name in the U.S. Patent and Trademark Office. He
calls it PACE®, which stands for Progressive Accelerating Cardiopulmonary
Exertion.

Many of his points are quite interesting and I'd like to
discuss a few of them. Let’s start
with that high-powered acronym.

The last two words, Cardiopulmonary Exertion, simply
mean the approach stimulates the heart and lungs to work harder and provide more
oxygen. It speeds up your breathing and heart rate.

The first two words, Progressive and Accelerating,
are the unique components, according to Dr. Sears. Accelerating means the
approach trains your body to respond more quickly—and adapt faster. As you
progress, you reach your target heart rate quicker and your breathing gets
deeper and more efficient sooner. You will also recover faster. Your heart rate
and breathing return to normal in less time. The compression of time
to peak exertion and back to resting level makes workouts shorter, a
refreshing concept in endurance training. (Arthur Jones made a similar argument
in strength training four decades ago.)

That brings us to Progressive, the real breakout
feature. Sears had been using most of the PACE program for 25 years before
adding this element. “More recently,” he writes, “I added progressivity
to increase the benefits.” (Perhaps he never heard that Milo of Croton became
the strongest man in the world by lifting and carrying a calf every day until it
grew into a full-grown bull. More likely, it didn’t occur to him that overload
applies to endurance training as well as strength training. In any event, he
caught up fast—and moved ahead of the cardio crowd.)

“Exercise can dramatically change your body over time
only when you change what you are doing over time,” he explains. (Emphasis
mine) “You have to do a little more of one component each time you do it.”

That’s where interval training leaves traditional aerobics
and cardio in the dust.

Supra-Aerobics

Sears says we are made for stop and go exertion. “For our
ancient ancestors, exertion came in short bouts followed by rest,” he writes.
“They didn’t run marathons or jump around for an hour at a time without a break.
Whether hunting prey, escaping from predators or fighting for our lives, ancient
humankind lived in a world where short, intense exertion was followed by periods
of rest and recovery.”

We are not made for aerobics, according to Sears. It’s not
the way to exercise. Moreover, he believes aerobic training, as generally
recommended by doctors and others, “can actually wreck your body. Do it long
enough, and aerobics will make you sick, tired and old before your time.”

The problem, as Sears sees it, is steady state exercise.
“When you exercise aerobically, you have to keep the intensity at a medium
level,” he explains. “If you increase or decrease the exertion level much, it is
no longer aerobic activity.”

As we’ve written here before, that’s not true. Our aerobic
energy system continues working at maximum capacity when we cross the so called
anaerobic threshold. Our aerobic and anaerobic energy systems work side by side.
For details, see New Thinking on Lactic Acid
http://www.cbass.com/Lacticacid.htm

Here’s the problem, says Sears: “If you never cross
that threshold you never signal your body to increase lung [and heart] strength
and reserve capacity.”

To clear up the confusion, Sears has coined a new
term to describe when you exert yourself beyond the anaerobic threshold but you
are still using your aerobic energy system as well. He calls it
“supra-aerobics.”

Okay, you say, but can traditional aerobics actually be
harmful? Dr. Sears believes so, and he may be on to something.

Aerobics Harmful?

Dr. Sears goes into considerable detail, but here’s his
bottom line: “When you exercise for long periods at a low to medium intensity,
you train your heart and lungs to get smaller in order to conserve energy and
increase efficiency at low intensity.” It’s specific adaptation to imposed
demand. You’re not prepared for greater stress. Your heart, lungs, blood vessels,
and muscles give up maximum output while preparing for long, slow exercise.

Sears says that’s why marathon runners drop dead every
year. Their bodies are not prepared for the unnatural stress of running 26+
miles.

“Your body doesn’t know whether you’ve run a marathon…or
been hit by a truck,” says an expert quoted by Sears. “Their hearts appear to
have been stunned.”

“Exactly,” says Sears. “During long-duration exercise, your
heart is under constant stress with no time to rest and recover. If it goes on
for long enough, your heart is traumatized and your body reacts by triggering a
wave of inflammation.”

As I was writing this, a new study was announced confirming
that marathon runners suffer heart damage. Eric Larose, a professor of
medicine at Laval University in Quebec, was running in a marathon when a younger
runner close to him collapsed and died near the finish line. The incident
prompted the study which he reported at the 2010 Canadian Cardiovascular
Congress.

Larose and his colleagues recruited 20 healthy runners in
the 2008 Quebec City Marathon; the runners ranged in age from 21 to 55. They were given exercise,
blood, and MRI tests 6 to 8 weeks before the marathon, two days after, and three
months later.

The tests showed that during the race, over half of the
segments of the heart lose function due to an increase in inflammation and a
decrease in blood flow. The less fit runners showed greater signs of injury,
said Larose. They experienced greater loss of function associated with lower
blood flow and greater irritation of heart segments, he explained.

Most of the damage had disappeared at three months.

Dr. Sears would probably say that the runners would’ve
faired better if they had incorporated intervals into their training program.
He’s not against endurance training, as long as it’s not your only exercise. “By
supplementing your endurance training with a PACE routine, you’ll actually
improve a broad range of athletic capacities,” he said.

Two more topics and then I’ll let you have at the book.
First, I want you to hear about a study Sears did with identical twins comparing
the results of endurance training and PACE. The results are eye popping. And then
I’ll give you a thumbnail rundown on how PACE works.

Cardio Versus PACE

Twin 18-year-old girls came to Dr. Sears with almost
identical body composition measurements. They were typical teenage girls, not
fat and not skinny. (I’ll use Dr. Sears’ words to describe the study.)

At the start of the study, both twins ran one mile each,
three times a week. Over the course of 16 weeks, the PACE twin progressively
decreased her distance to fit the PACE program. The cardio twin
progressively increased her distance to match a traditional cardio
routine.

By the end of the study, the PACE twin was sprinting
6 exercise sets. Each set had a 50-yard exertion interval followed by a recovery
period of 30 seconds. The cardio twin was jogging 10 miles
straight with no breaks.

The results? The PACE twin went from 24.5% body fat all the
way down to 10% for a total fat loss of 18 pounds. What’s more, she gained 9
pounds of pure muscle.

The cardio twin lost fat, but not as much. She also started
at 24.5% body fat but went down to only 19.5% body fat for a total fat loss on 8
pounds. Not bad, but instead of gaining valuable muscle, the cardio twin
actually lost 2 pounds of muscle.

As I noted above, a characteristic of the PACE program is
that the training time decreases, while the typical cardio program gets longer.
In this example, the PACE twin exercised for one quarter as long as the cardio
twin.

Finally, let’s look at some key elements of the PACE program.

PACE, in Brief

Perhaps the most praiseworthy aspect of Dr. Sears’ PACE
program is that it makes interval training accessible to anyone who is mobile.
If you can move, you can do PACE. Sears has designed a program for all levels of
fitness. The before-and-after photos scattered throughout the book look like any
Joe or Jane who might walk into a doctor’s office. They are not
models.

“Some of my patients feel a high level of exertion after
walking for 60 seconds,” Sears writes. “Others can sprint for 50 yards and not
even break a sweat.” PACE will work for either extreme.

In one example, a 56-year-old lady weighing 250 pounds
started out walking for just 45 seconds. All she did was walk for a few seconds
and rest for a few seconds, and then repeat. That’s all she needed to get
started.

“[During a series of] weeks, [she] went from walking for 45 seconds
to ‘power walking’ up steep hills,” Sears recounts. “Today she can run, sprint
and workout with weights.”

As noted earlier, progressivity is a key element of the
program. Another is change. You have to keep challenging your body and change
what you’re doing over time.

You begin by slowly working up to maximum effort, and then
you rest. (Maximum is what challenges you at first.) Once is enough to get
started. From there you add reps, exert yourself, rest, and then do it again. A
unique feature is that the rest periods are flexible. You rest until your heart
rate and breathing come down and you feel ready for another rep. Total exertions
periods on average are about 12 minutes; don’t count the rest periods. You can
do more if you like, but Sears suggests keeping total exertion time under 20
minutes.

Another distinguishing feature is that the exertion periods
often vary during the course of the workout. You might begin with a 4 minute work
period and end with 30 seconds. Or you can do it the other way around; start
short and end long. Mix it up; do it one way in one workout and change the next.

You can walk, run, bike, swim, or whatever you like. It’s
best to change what you do from time to time.

Many more details can, of course, be found in PACE:
The 12-minute Fitness Revolution.

* * *

I’m sure Dr. Sears would agree that many aspects of his
program are not new. (I’ve used and written about many of them myself.) Sears,
to his credit, has created a version unique in application and scope. And he has
packaged and explained it superbly. As I’ve already said, the flexibility and
accessibility are unmatched.

My compliments to Dr. Sears. He’s doing great work.

* * *[

Readers Speak Out

[Many readers commented on this article.
Here are two exchanges we believe you'll find thought provoking.]

Clarence,

I would prefer to go against most of the conventional thinking.

For me, it makes total sense, that our always quoted ancestors of
thousands of years ago, were anything but " brief periods of action followed
by significant rest periods." Our ancestors had to do everything themselves.
Chopping trees, making shelters, walking, JOGGING vast distances to move, hunt, forage, see neighbors, keep the territory safe, see what was
over the horizon. This went on for thousands of years.

Still to this day, those people who have to hunt without bullets will
have to run their prey to death. That takes hours.

The way some of these articles are put one would think a man of those
times could simply out sprint animals to kill them!

Only when serious danger was imminent would one have to sprint.
Otherwise, every day was endurance day; so in fact the one thing man would
avoid where possible would be intense periods, because that would lead to
early fatigue. Fighting was intense...those battles could last a day or
more.

Modern man has developed the "frantic" brain.........." gotta, gotta,
gotta...". Everything has become rush mode, from business, to games, to even
leisure (what's leisure?!). Because we lack the real macho achievements of
those before us, we have to invent macho pastimes, and pain is part of this.
That comes from the intense "lift as much as you can, as quick as you
can"...and the same for running/cycling etc.

Of course this has a tremendous training effect, when done judiciously
and with common sense. But where is that today? Gone for the most part.

The long periods of cardio have been abused along with the above, because
people attack the long distance training too hard, and that of course will
wreck anybody, as will doing intervals too quickly and too often. Long and
slow is an incredible strength builder and metabolic booster, when done
correctly and as part of one's approach to a fit life, let alone a race or
an event.

I am also firmly of the opinion that when one is pushing hard
intervals or intense weights ( both of which I love ), gas should ALWAYS be
left in the tank. You basically give your all only when competing, so you
are able to train day after day with plenty of energy.

I continue to admire your work, as you are your own guinea pig....and I
humbly submit that the authors of most of the articles that are against the
prolonged cardio, are people that have never really tried it at all, ( as
part of a sensible fitness plan) and do not like it ( in which case there
is bias ).
As one of your top long distance gurus has noted..." ya gotta slow down to
go faster "....and he has been around for years and tested it all and
achieved it all.

Sincerely,

Richard Stent, South Africa

Clarence's Reply and Reader Follow-up

Hi Richard:

Thought we might hear from you on this one.
Very well stated, my friend.

Likely truth is that ancient man did all combinations short, hard and
long, slow--whatever was required for survival.

The problem is that some, including doctors and some personal
trainers, believe that crossing the anaerobic threshold is not necessary
and may even be harmful. We've both seen people in fitness
centers riding bikes while reading their newspapers. They simply don't
get it--and probably don't want to.

If you do long, slow, you should also do short, hard. I know you do
both.

As suggested earlier, the two types of adaptation are complementary.
Either extreme, however, can be problematic. For example, the
researchers point out that “ultra-endurance exercise is thought to be
associated with a predisposition to ventricular tachycardia [abnormal
rhythm] and sudden cardiac death, which is common in male athletes.

As we've discussed before, you're inclined toward long endurance, and
I'm disposed to short, hard stuff. The idea of running a marathon has
absolutely no appeal for me. You, on the other hand, are just getting
warmed up at 26 miles. Yet, we are both pretty fit.

Problem is that some people have no business running marathons; as the
doctor quoted in PACE article says, their body thinks they've been hit
by a truck. They're asking for trouble.

My guess that very few people living in ancient time would have occasion
to run 26 miles without stopping--certainly not by choice. Even when
chasing prey they probably stopped to rest every chance they got. Prey
also stopped when possible.

So there is no one best way. Doing a little of both would probably be
best for most people.

Remember too that Al Sears isn't talk to guys like us. We probably
don't need him. But that women who could only go for 45 seconds, she
needs him. She's his patient/audience. Of course, there are far more
inexperienced trainers and people in terrible shape (like that women)
than people like us. We're the exception, not the rule.

Remember, only 5% of Americans are physically active on any given day.
Probably more in Australia and perhaps where you live.

I admire and appreciate you, my friend. You're the real deal and I love
hearing from you.

Clarence

Right on, Clarence...many
thanks for the reply.

I have to tell you this.......any endurance
work I do over 2 hours is always very slow, and includes plenty of
walking!

I will only do this once a week maximum, and the rest of my
training is short and hard....including weight training.

I actually detest marathons...and would rather do something
longer, because then I do not feel guilty walking!

I love short and hard, and have trained that way for many years.
However, I simply have always found that a long run once a week does
wonders for overall conditioning (something top weight training coaches are
talking about more often). A long run can be one hour, or three.

Richard

Another Reader Comments

Clarence,

Dr. Sears' book is probably the most sensible of the
publication on intervals I've seen since being
introduced to the subject 30 years ago, when I first got
into running.

However, I want to point out that Dr. Sears has made
a number of questionable claims, including the
following condensation in your article:

The problem, as Sears sees it, is steady state
exercise. “When you exercise aerobically, you have
to keep the intensity at a medium level,” he
explains. “If you increase or decrease the exertion
level much, it is no longer aerobic activity.”

Dr. Sears goes into considerable detail, but here’s
his bottom line: “When you exercise for long periods
at a low to medium intensity, you train your heart
and lungs to get smaller in order to conserve energy
and increase efficiency at low intensity.” It’s
specific adaptation to imposed demand. You’re not
prepared for greater stress. Your heart, lungs,
blood vessels, and muscles give up maximum output
while preparing for long, slow exercise.

Which is something the sports medicine world has
noted for years. In fact, after I became a "hard
core" runner (in my 20s, having never competed
or trained in school), at my best, I was running
a sub-4:20 mile and <15:00 5k with a resting
heart rate of 32bpm and 88/60 blood pressure. I
found this out because I would get light-headed
when standing up too quickly...the flight
surgeons in the military finally figured out
that my extremely low pulse was due to my larger
heart (adapted to the training) and
"outstanding" per stroke volume of blood my
heart was able to generate. (As Dr.
Leonard Schwartz
called it, I had the classic athlete's
hypo-tension vs. hyper-tension.)

So, based on your October article and the
(objective) research performed, aerobic
training does increase the size of one's
heart and, per some researchers, lungs. I've
actually contacted Dr. Sears' office and
asked if they could cite the research he's
citing to back this statement, however, they
only had one vague reference that did not
equate to the years of studies that have
shown the opposite of what he states.

Also, when you decrease your exertion
level, you're still "aerobic". Big
error by Dr. Sears in that
statement...one can be doing a slow walk
and that is aerobic as is cycling at 60%
of your max heart rate.

Another problem: Dr. Sears,
unfortunately, appears to be lumping the
steady state aerobic types--the people
who get on an Elliptical Trainers,
Indoor bikes--with people who get
outside and train in the real world.
I've never, ever done any steady state
running were the road(s) have been flat
and there's been no wind. Rarely is that
the case. Example, Running in (flat)
downtown Chicago on the lake was a
blast, when the wind was at my back.
For my 40 minute run this morning, I
covered one gradual .5 mile incline and
a shorter (.1) incline on the way out,
heading into an 8 - 9mph headwind. On
my return, I have a .75 mile hill before
turning into my neighborhood.

Apologies for the long email, but,
as much of Dr. Sears' information,
as I understood from his office
staff, is the result of a 'net
research service, I wanted to bring
some of the inconsistencies or
possible mistakes in his claims to
your attention.

As always, best to you and Carol and
thanks for your work!

Parker Reed, Texas

Clarence
Replies

Hi Parker:

Thanks for interesting feedback.

Dr. Sears would probably agree
that most serious runners, such
as yourself, include plenty of
up and down intensity in their
training. Unfortunately, many
less experienced trainers have
been led to believe it's best to
stay in the so called aerobic
zone, for fat loss and fitness.
That can be a problem.

Others are attempting marathons
without proper preparation,
which can can present major problems.

Finally, many are afraid to
attempt interval training.
That's where PACE can really be
a Godsend.